1 / 6

Presented by Jason Kessler , M.D., M.P.H No disclosures or conflicts of interest to report

Modeling the impact of focused strategies on the cost and effectiveness of TLC-Plus (or "Test and Treat") in New York City . Kessler, J. Myers, J.E. ; Nucifora, K.A. ; Mensah, N. ; Kowalski, A. ; Sweeney, M. ; Toohey, C. ; Shepard, C. ; Cutler, B. ; Braithwaite, R.S.

mahon
Télécharger la présentation

Presented by Jason Kessler , M.D., M.P.H No disclosures or conflicts of interest to report

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Modeling the impact of focused strategies on the cost and effectiveness of TLC-Plus (or "Test and Treat") in New York City Kessler, J. Myers, J.E.; Nucifora, K.A.; Mensah, N.; Kowalski, A.; Sweeney, M.; Toohey, C.; Shepard, C.; Cutler, B.; Braithwaite, R.S. Presented by Jason Kessler , M.D., M.P.H No disclosures or conflicts of interest to report July 23, 2012 IAS 2012

  2. Background and Objectives • Background • HPTN 052 strengthened evidence base for HIV treatment as a prevention strategy • TLC-Plus: community level “test and treat” intervention being tested in HPTN 065 (Bronx, NY and Washington DC) • Objectives • To evaluate the impact of prioritization of TLC-Plus strategies in New York City (NYC). • To identify optimal prioritization strategies for given budget scenarios (i.e. “biggest bang for the buck”)

  3. Methods • Integrated compartmental model (transmission) with microsimulation model (disease progression) • Background Inputs: • HIV testing probability (per year) = 31% • Linkage to care probability (within 90 days) = 75% • Adherence probability= 63% • Intervention effects: • Increases HIV testing probability by 33%, linkage to care by 30% and adherence by 20% in prioritized population • Secondary effects of increased condom usage, and more monogamous relationships • Prioritization strategies compared: • General population (1) • All MSM (3) • All IDU (4) • High risk sexual networks (HR) • all (2) • among MSM (5) • among IDU (6) • among MSM/IDU (7) 1 MSM 3 2 6 7 5 4 IDU High risk sexual networks (HR)

  4. Impact of different prioritization strategies of TLC-Plus over 20 years in NYC % of HIV infections averted New HIV infections % of HIV infections averted Number of new HIV infections

  5. Efficient frontier of prioritization strategies of TLC-Plus General population All high risk sexual networks % HIV infections averted All IDU All MSM High risk sexual networks among IDUs High risk sexual networks among MSM High risk sexual networks among IDU/MSM Total cost over 20 years - US$

  6. Conclusions • TLC-Plus can prevent thousands of new HIV infections in NYC • With conservative assumptions we find more modest impact of TLC-Plus than other models of “test and treat” strategies • Focusing implementation of TLC-Plus among certain subpopulations (or neighborhoods where key subpopulations may concentrate) can render this intervention more cost-effective • Increase in feasibility.

More Related